Most States Still Aren't Funding Tobacco Prevention

Billions in revenues from settlement, taxes being spent elsewhere

Less than 2% of the $26.6 billion collected by states from the tobacco industry settlement or taxes on tobacco products this year will be spent on programs to prevent kids from smoking or help smokers kick the habit, according to an annual report from a coalition of health organizations.

The $491.6 million allocated by all states for tobacco prevention programs in the current budget year represents just a small fraction of the $3.3 billion recommended by the Centers for Disease Control and Prevention (CDC).

The joint annual report was released early Wednesday by the Campaign for Tobacco-Free Kids, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, the Robert Wood Johnson Foundation, and the American for Nonsmokers' Rights and Truth Initiative.

The coalition noted that adult and youth smoking rates continue to decline at an accelerated pace and have fallen to record lows. In 2015, just 15.1% of adults in the U.S. smoked, according to the CDC, compared with 42.4% of adults in 1965.

And from a peak of 36.4% in 1997, the smoking rate among teens dropped to 10.8% in 2015.

The analysis, by Michael C. Fiore, MD, MPH, MBA, director of the Center for Tobacco Research and Intervention at the University of Wisconsin School of Medicine and Public Health in Madison, credited actions taken by the federal government during the past 8 years for the accelerated pace of the smoking decline.

This success highlights the missed opportunity by state governments to further reduce smoking rates, according to the report.

"It is extremely disheartening to report that year after year, states have the means to bolster tobacco prevention efforts and save lives, but simply choose to divert their settlement funds elsewhere. ... We must continue to push lawmakers to right this wrong and do more to protect lives from the dangers of tobacco," American Heart Association CEO Nancy Brown noted in a press statement.

During the current fiscal year, $8 billion in state revenues were projected from the landmark tobacco settlement and $18.6 billion from tobacco taxes.

Just two states -- North Dakota and Alaska -- currently fund tobacco prevention programs at CDC-recommended levels. With the exception of Oklahoma, no other state funded such programs at even half the recommended level, the report noted.

Other key findings included:

Twenty-nine states and the District of Columbia will spend less than 20% of the CDC recommended levels;

New Jersey and Connecticut have allocated no state funds for tobacco prevention programs during the current budget year, and Missouri and New Hampshire allocated less than 1% of the CDC recommended funds;

The current state funding of $491.6 million for these programs is more than 30% less than the $717.2 million spent in Fiscal Year 2008; and

Tobacco companies continue to spend much more to promote their products than states spend on tobacco prevention.

According to the Federal Trade Commission, major cigarette and smokeless tobacco companies spent just over $9 billion to promote their products in 2014. That represents $18 for every $1 spent by states on smoking prevention and cessation programs.

States that have implemented sustained tobacco prevention programs continue to see progress that is outpacing states without well-funded smoking cessation initiatives.

North Dakota reduced smoking rates by nearly half among high school students between 2009 and 2015, and Florida, with one of the longest-running programs, reduced high school smoking rates to a historically low 5.2% in 2016.

"Florida has cut its high school smoking rate by 81% since 1998," the report noted. "Launched in 2007 and based on the CDC Best Practices, the Tobacco-Free Florida program is a key contributor to these declines."

Support for the report was provided by the Robert Wood Johnson Foundation.

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